How important is an official diagnosis?

I had sagging and after 3 yrs of rejecting surgical help caved in. I now have at the back o fmy vagina some plastic screen like mesh which has eroded or wore into my flesh to such an extent that i sag more than before. I feel i left myself down by caving in but must go forward...
I bleed a bit and have fluid discharge....ridiculous it seems that this was done--I can't imagine dental surgery being so poor! The doctor the first surgion referred me to cannot understand why this was done to me...I asked why do they teach this procedure.....

Hi Ribbit

How about asking the doctor why he ordered it.

What information is he going to get that will help you to decide whether or not to have surgery?

Also, what information will he get from it that he doesn't already know?

Also, what use will he make of the information, other than to tell you that you should have surgical repairs?

If you already know you have POP, and don't want surgery, then don't have the MRI.

If you are open to surgery, then you will eventually need it, but not until you have decided that surgery will definitely happen.

I guess that means that I can see little point in having it, except to get your doctor off your back. Ask yourself who is going to benefit from it.

MRI's have recently, if I remember correctly, been taken off the perfectly safe list, as there is radiation involved.

I would just be getting on with practising Wholewoman techniques. That is going to get you further towards recovery than having any MRI or any type of scan, for that matter!

Louise

Hey Ribbit, Get the MRI but get it to explore this back pain you are having!
It's painless for sure and it's nice to know what is really going on. Your back pain sounds so much like mine- and I recently had an MRI to see what was bugging me so much- and I have some significant damage that showed up loud and clear!

Fair call, Alemama, but Ribbit needs to ensure that the MRI is done specifically for each condition that is being investigated. I don't know if they set it up differently for colo-rectal investigation vis a vis spinal investigation. She would have to discuss that with the doctor. That's why I think she needs to dialog more with the doctor, so they both get the information they want.

I'm feeling bossy. Ribbit so many of your symptoms could be related to disc health. For me there have been a number of flags in your writings that scream disc- 1. the sacral support feels great 2. the full colon causes back pain 3. your history of moving heavy things 4. your compromised nerve communication 5. the exercises helps you feel better.

certainly you could have pain from the organs pulling, sure it could be muscle spasms. The best way to know is to take a look.
Diagnostic medicine in the USA is really cool. I paid $300 for an MRI and took home a disc full of images. Really neat stuff. It was quick and easy. In fact I got the MRI the same day I went in for back pain- and you are right - the tech who does it can not say anything to you- but the results were @ the doctors office in 24 hours with the radiologist's report attached.
Not that there is anything you will really want to do about it if you do find damaged discs- just that it is good to know so you won't unknowingly blame it on the prolapse.
One last thing....knees and elbows! I swear I spent 6 months like that and I am so glad I did. The kids got used to it- in fact that was my son's favorite way to nurse- under me like a little baby koala.

I hope you are able to get this sorted out soon!

Hey Ribbit- you can google yourself to death reading up about discs and disc health and prolapsed discs and spinal nerve encroachment and degenerative discs and slipped discs
Basically everyone has disc damage over their life time (just like everything else in the body wears out). You can hurt a disc doing something as simple as switching the laundry over or shoveling dirt- Pregnancy is hard on discs too- so is weight gain.
I've read some really interesting studies about disc damage and how most people have it but only about half of the people who have it are actually symptomatic. Weird.

I can't say one way or the other about chiro- chiropractic care certainly does not prevent disc injury and some argue that it can cause it-
for me personally I like to have an adjustment- especially when I am pregnant.

Well Ribbit, I have come to the conclusion that my raggedy old lumbar discs were damaged by forty years of trying to straighten my spine out while lifting. I think this placed more pressure on the front of the lumbar discs and they blew out the back.

Also, there is a neat thing about the spinal processes that stick out the back of the spine. If you allow your lumbar curve to curve when you lift, it squashes the spinal processes (which are solid and quite short) on top of each other, like the edge stones in a stone arch. The more the lumbar curve is accentuated (within reason) the tighter they are squashed together, and the more they prevent the discs from squeezing out between them, and rupturing. The key is to only lift loads straight on. If you twist too much they are likely to topple off each other. Then the discs take all the pressure.

Further up the spine in the thoracic and cervical sections, the processes are longer, and point downwards. When you lift a load these processes overlap each other, the top one coming down over the bottom one, transferring much of its load to the vertebra below. They lock the vertebrae together and prevent these smaller discs from shearing off.

The spine is not a vertical column at all. It is a stably stacked skyhook which becomes stronger in compression as a result of its curves.

That's my theory, anyway. Ms Thrifty (my toy skeleton) has taught me so much!

Louise

I see a bowel specialist this week the elder and caring ob gyn that I now hve seen thinks there may be risk of mesh eroding into exterior bowel... may need resection---??My God ---whats this about-- the MRI I had shows 4.5 cm of mesh in there along with diverticuli---This mesh thing must work with some women- our species are not entirely uncaring IDIIOTS I have huge Cystocele on other side of my cervix where the uterus used to be. Standing makes me want to throw up and no doctor has suggested I take a sick leave from my job ...lifting and standing on cement floors, I am feeling pooly and stressed.

((((sammy))))
my greatest sympathies. I hate this for you. What in the world are we doing to women? and to not suggest sick leave- as if they would ask any man to remain working if he were having these symptoms. Why is it that Women's heath issues are shrouded with such mystery? For goodness sake- mesh eroding into your bowel- ugh of course you need to be resting at home. But since it's a women's health issue off to work you are expected to go- as if having a vagina is an imaginary thing. blah. humanity.

They do not yet know if the mesh is in my bowel -it is one of the risk factors- My bladder is pushing my cervix and vagina way out of my body rite now and causes burns on my skin from friction- this is much worse than the uterine prolapse was...I see the bowel surgeon only to have her get familiar with me - this week
The older, kinder and wiser gyn/ob that i now see does not understand why I was not offered a pessary- I have a sickening feeling that the doc I saw(2nd opinion) who simply told me a pessary would not work for me perhaps did not want to bother with it This is awfull...

Sammy, I am so sorry you are going through this. I think all you can do is go along to the bowel surgeon this week and find out what she has to say. I would suggest that you specifically tell her that you want to know what she thinks, and that you don't want it shrouded in secrecy, for only your doctor's ears.

You are obviously a gutsy woman who is sick of doctors playing games with your body and your mind. Don't let them treat you like a victim, any more than you would treat them as demi-gods. You are obviously way past that.

You are your own woman, and you know that we will support you and do our best to help you to think clearly what solution you want. I think you will be able to deal with anything they can tell you. You can't go on like this.

Be brave. Be wise. Try not to get emotional about it. Post back and let us know how you went.

Louise

Thanks Louiseds I do appreciate your care...
It was a female GI and I left her feeling good. She said she did not think the mesh had eroded into my bowel as the vaginal secretions do not indicate bowel involvement. Being 62 - i hve diverticulosis as shown by MRI ( side effect of MRI are indictions of other disease) She said this divertculosis is common as you age and suggested I continue with Phslium husk treatment.. I think she knew the mesh needs to come out...(she was either stiffling a yawn or weepy eyed from the troubles I had)
I need further consultation with wiser older ob/gyn... TIme stands still....
Wish I had never ever had this mesh put in....would not advise this to anyone...

The way I read it, there is some hesitancy about recommending any scans left, right and centre, because they do seem to find unexpected things sometimes that may or may not cause problems in the future. However, I guess if a doctor finds something s/he is bound to treat it, or at least offer treatment, regardless of the likelihood of problems developing later. Many strange things seem to correct themselves given time and good self-care, so it may be wasting health (sickness) resources $$$ to treat some things that are found inadvertently. Also, sometimes treatment itself will prove damaging, so there is little point in doing treatment if the condition is not causing bother.

Louise

Ribbit, sorry, I wasn't telling you to have the MRI or not to have it, just clarifying that philosophical point about what happens if they find something they are not expecting to find.

If they might come closer to finding out what is causing the pain I wouldn't think twice. If anything, they might be able to rule some nasty things out. I wouldn't refuse to have an MRI, just on the basis that I was scared what they might find. No way!

L :-)

Sorry, u was trying to be funny- my MRI showed severe diverticulitis and now am being told differnt things by different professionals regarding a colonoscopy for these diverticuli. The GI recommended a virtual colonoscopy first and then if necessary a colonoscopy because the surgery i had made the colonoscopy more risky. The GI said that many many over 60 have diverticulitis why do anything....

Hi Ribbit:
What causes your severe pain- is it the prolapse???
I have suffered prolapse for years and would not say the pain was ever severe.. I have pain now because the cystocele (bladder) seems to be trying to fall rite out and it is too big- it causes scalding but i use diaper cream which helps immensley. The pain is not severe...
Do you need the bathroom to empty your bladder often?? I too can't bear not going when I have to because of the cystocele falling more with increase weight.

My sister had a prolapse with her 4 th child but it went back up and has not bothered her for years....
Your childeren will first of all want for you to not suffer..they just love you so much... There will be times others can go with you to park... You have lotsa time if there's a toddler...

I spoke with a Gastrointerolgist on tues of this week and she said taking a Psylium husk drink with lots of water is recognized as a safe and effective way of keeping the bowel moving . She warned that lots of water must be drinken as wll or it may have the reverse effect and bead up the movement. Llife brand has a cheaper powder than Metamucil. I am impressed with how it works but am still cautious because it is new to my diet. I find yams and carrots keep me soft.. Without frequent bowel movements, I get very heavy and so uncomfortabale that is is simply unacceptable... She recomments a "virtual colonoscopy' for me .because my BM have so many funny shapes lately but i think this is beacuse of the saggs inside me- ..I have made appointment with my family doctor to discuss this May 10 I have abeen wearing Always pantyliners for seveal years now because of the erosion as a result of the mesh and consequent body fluids from granulamtous formation ( i think my blood tries to get rid of the bothersome foreign mesh) The GI said they aren't too concerned about my vaginal bleeding because they know the cause...regardless it concerns me- especiallly the feeling inside me concerns me.
if you are improving hang in there.... I wish this mesh was never recommended to me, if they had told me I would feel it in my tailbone for the rest of my life it would have been as sure "now way"but choices are made rite or rong...

honestly, can we put that into the 'barbaric' category?
I'm so sorry you were put through that.
(note to self: avoid prolapse MRI!)

do you have to go back?
will it make a difference in how you will proceed?

and if you do go back tomorrow, good luck!
will be thinking of you

I am sorry to hear that you have a bulging disc, though I did suspect it. Do you have a plan for what you want to do about it?
I can say with great conviction that strengthening my body has helped me so much. I focus on my quadratus lumborum, glutes and abs.
Also, I love the ice plunge. Kills the inflammation.

As for the prolapse MRI, perhaps you can do it with much less enthusiasm? Fake it?
I would not do that test ever ever again.

Gosh I hope in the end it was worth something???? So sad for you.

So sorry to hear about the man-handling. However, aren't they mostly looking at severe constipation causes? They may be studying how your bowel moves upon bearing down. I would certainly inquire about that, since a prolapse diagnosis does not require imaging. ((((hugs)))) from Christine

That is horrifying. I'm sorry you were put through that. I would refuse to any straining if you need to go back. The tech should have to be made to figure out a way to run the test without worsening your condition!

If you decide to go ahead with this appointment, you have every right to demand answers before proceeding with any sort of procedures. Plant your feet firmly and take up as much time as you need to get some answers as to the reasoning behind this very strange procedure before deciding on whether or not to continue. They very well might have other methods that are simply more labour intensive and thus not as commonly used as the bearing down barbarism.
Good luck!

Hi Ribbit

What a horrible thing to happen. What a horrible thing to put a woman with prolapse through. However, you have found out that there is disc involvement, so you now have a reasonable explanation of the back pain.

The prolapse is something entirely different, and I assume they are wanting to repeat the MRI as an aid to diagnosis of prolapse that you know you have, and which was worsened by the initial MRI.

Who is going to benefit from a repetition of the MRI? You? How? I think it might only benefit the OB by giving him further information in preparation for recommending a surgical repair that you have said you are not going to see him about.

So why have it?

I think you will be able to improve the discs considerably once you have your body better supported. It will take time, but you will get improvement. I think Alemama is right. Once your spine is being supported more effectively by stronger muscles the discs will be under less pressure. If your posture is also supporting the spinal structure the discs will heal, just like mine have, even though it took several years to heal them.

If you really must have the second MRI, faking it is the only way to go, but I agree with Christine that an MRI for diagnosing prolapse is overkill. I think they use high tech scanning more than simple palpation because they are taught their trade with scans, and images, rather than with real bodies. Doctors no longer diagnose by feel. They just watch it on the tele because it is much cleaner, and they don't have to perform vaginal examinations that threaten women's personal space and can be pretty undignified. It is so much less threatening to plug the woman into a machine and read the pictures.

Just my personal opinion.

Louise

I'm seconding all this! If they are just diagnosing POP, how about checking you out personally. I saw a top urogyn here, and he diagnosed me lying down and from that could tell what everything would be like standing up. so clearly, it can be done, but takes experience.

on the other hand, if they are looking for something else, i'd find out exactly what, why you have to have an MRI for that, why you have to bear down, and what the result will show. also why are they having to redo it? could it happen again and again?

also, think through what this means for you. if you come away and they say yes, you have a POP, what does that mean for you diff't to now? are you going to change strategy if they confirm your POP?

but as Christine said, if the constipation is what is being investigated, and it might not be about POP, then i'd discuss that. and why do you need to bear down if they are looking for something else?

lots of questions to ask.
good luck and let us know...
Kiki

Hi Ribbit

Grrrrr too! All the special language is very hard to understand, but your doctor will be able to decode it for you. I think you need to go back to the doctor who prescribed the scan in the first place and find out what he has learned from the results, and what he has not learned, and what he still needs to learn. He may have the constipation answers he needs, but he might want another scan to find out more.

If he wants another scan you can phone the radiography clinic, tell them what he has ordered, ask what happens during it, and decide for yourself whether or not you are willing to undergo it, balanced against what the doctor can learn about your bowel from the scan. You have to be happy with what they are doing to your body. At the end of it all you will hopefully have more information.

If it is simple constipation you are probably the best person to deal with it.

Just a thought, are you taking any medications, natural or manufactured, that might constipate you?

Louise

Ribbit, at the age of 6 my daughter had terrible constipation and bowel incontinence that did not respond to any of the normal treatments. After the paediatrician basically said he couldn't help any more I figured that the nerve signals were not getting through, and took her to a chiropractor. She was 80% fixed after only a couple of treatments, and two years later almost completely cured. She has never had a recurrence of the problem. Her bladder incontinence was fixed too. I am wondering if you might have something blocking the nerve signals that are responsible for bowel motility, perhaps something that happened during the birth? It might be a long shot but if it pays off it could mean an enormous difference to you.

The chiropractor was amazed at the difference it made with DD, and wrote it up as a case study. The paediatrician remained unconvinced that it was any more than coincidence. Needless to say, we didn't go back to the paed.

L

Hey Ribbit
I've been wanting to get to this for a while but we've had some busy days.
ok I can explain most terms:
as to the L4s or T3 etc- they label the spine bones- Cervical for the neckish ones, Thoracic for the midback, and Lumbar for the lower- S for sacral.

Alignment and bony structures: There is a slight levoconvex curvature centered at the L4 level (a compensatory curve in the spine) Normal lordotic curvature persists (so even though you have this weird twist to the spine your normal curve still exists). Negative for compression fracture (no broken bone). There is a small amount of marrow edema (fluid buildup in) in the anterior-superior(front-top) corner of L4 (lower back).

Conus medullaris: Normal size, signal and position.

T12-L1 disc space(the disc between the last thoracic vertebrae and the first lumbar vertebrae): Mild degenerative disc disease (break down of disk- which by the way is made of a squishy, jelly substance that kinda over time wears out- calling it a disease is a misnomer since it is just what happens to every human over time- the discs lose fluid- become dehydrated give less support). Canal and neural foramina are patent (patent is good- open).

L1-2 disc space: Normal.

L2-3 disc space: Normal.

L3-4 disc space: Normal.

L4-5 disc space: Mild degenerative disc disease (so another disc with less fluid). Small left neural foraminal focal disc protrusion is present (this is an injury- the disc is no longer sitting balanced between two bones supporting them- it is squishing out). The protrusion is centered in the medial portion of the foramen. It is just inferior to the exiting left L4 nerve root. This also is just lateral to the lateral recess, (this is just a bunch of directional terms to tell us where the disc is now- looks to me like it's very close to a nerve root- this can give you significant pain and I suspect even cause constipation- because the disc can block the nerve signals- some people with this injury lose control of bladder and bowel function) which is slightly narrowed. Canal is patent (this is good remember?). Right neural foramen is patent.

L5-S1 disc space: Unremarkable.(we very much love unremarkable in this situation!)

Impression:
Mild L4-5 degenerative disc disease. L4-5 small left neural foraminal focal disc protrusion is present.

So there ya are- clear as mud?
what's going on is that you have some disc issues- a bit of a torque to one of your vertebrae (L4)- but so far they don't see a big compensation for it- and the disc at L4 needs love.
So I don't know how you will sort out your L4, but that is where you might like to start. Ice it- eat lots of pineapple- no straining or heavy lifting

Ribbit, as this particular pain started with chiropractic treatment during your pregnancy, and has not resolved spontaneously, I think it needs resolving one way or another.

There is a quote from Albert Einstein. "Insanity is defined as doing the same thing over and over again and expecting different results". If your chiropractor has not been able to resolve this pain, perhaps a different chiropractor could look at your body differently? I am sorry if I seems to be harping on about this, but I can see that you need to look at all possibilities. I would still be open to the constipation, the pain inside your hip and your nerve signals being related.

Louise

PLEASE don't vacuum all at once---train yourself to do 5-10 mins a day or a room a day.....WORk with who YOU are now (hard to realize we've changed....)

when I've got more than one kid in the shopping cart, I find it easier to pull the back end of the cart behind me when attempting to turn it. for some reason I find that easier. but of course I would only do that if I was fairly certain that the child sitting up in front was safe without me up there. and yes, leaving them home is always easiest, but not always possible. my local supermarket will deliver my groceries after I've shopped for a $2 fee. if only the little ones are with me, I gladly pay it (if the two older ones are along they help load/unload so no need).
for $6, they will shop from my emailed list and deliver. something I availed myself of in the winter when I was still newly pp and had no energy to deal with a newborn, 3 yo, groceries and ice/snow.
how old are your kids?
can they learn to vacuum?

I hear you, ribbit. my little ones want to 'help' wash the dishes and it takes me twice as long to redo and clean up the floor and countertop than it would've for me to just do it in the first place. but its how they learn....
but are you sure they can't be really helpful? my kids are pretty helpful when it comes to unloading groceries, like I said its mostly the bigger ones (11 and 9) but my 6 yo can make a few trips from car to house and even the 3 yo helps unpack. it takes longer, but I'm not doing all the bending. my 6 yo happens to be really good at vacuuming too. he doesnt' get under the beds or into all the corners, and he won't pick up shoes or toys (will just go around) but if I (or one of the other kids) prep the room he actually does a fairly good job.
I have my 6 and 3 yo's dragging laundry baskets too, I thread one of dh's old belts through the basket and they pull, dragging the basket to teh laundry room (it helps that we don't have stairs).
your kids are still young and close in age, I cannot even remember what it was like then (we have similar spacing), when my oldest was 7. seems so long ago and it was only 4 years. goes so fast......

Hi Ribbit

I was very happy to see your last sentence, because it encapsulates the idea of using your body to reinforce its own stability!

Avoiding bending tasks is OK, but by avoiding them you are not getting to use all the muscles that keep your lower body strong. These are some of the muscles that keep your pelvis stable, so it might be defeating the purpose, and weakening your body in the longrun. Having said this, I don't experience your pain, only mine, so I can only theorise about this, and let you sort out the specifics for your body.)

Once they weaken you have to do exercises to strengthen them again. Boring.

I think in your situation I would be concentrating on bending from the hips and knees, and not from the waist. Going down is often not the problem. Straightening up again or standing up again, or lifting the object, is the problem.

All I can say is that this will pass. The load on a mum with a young family is enormous, and many of your movements are prescribed by your Mummy activities. As your children grow up you will be more in charge of how you use your body, cos they will be able do their own stuff for themselves, and for you.

Louise

It is frustrating not doing stuff, but that will slowly change. i too mourned not doing stuff outside, but this weekend i dug up plants, moved plants, and had a lovely day gardening. i jetwash, sweep, move light stuff around. i don't lift heavy pots, but as you are finding, there are work arounds. i lift to a limit i feel safe with, and as my little one gets bigger, that limit also gets bigger. today i carried several bags of groceries around at once, something i could not have done a year ago. so it just keeps improving. hang in there!
and glad you have a handyperson to help you. and children to muck in! great for them to be given the responsibility and know they are helping mom.

Our first was born 2003. Then 2004, 2006,2009. I love the close spaces so much!
Our 7 year old is helpful though, WAY helpful. She is amazing. Our almost 6 year old is pretty darn helpful too and if you put the two of them together there isn't much they can't do.
They all haul laundry for me, they clear their plates at the table, they put toys away- really life is so much easier than it was just one year ago.
Keep plugging away at this Ribbit! it gets so much better. I am glad you are working on hands and knees and elbows and knees. It really does help so much to do that.
There are many yoga positions that are said to encourage the bowels. I think the knees and elbows must be one of them. There is also the wind relieving pose- which you might like.
Now, how is your back feeling? Are you icing yet?